ALAMEDA COUNTY

Healthy Homes Department Fourth Quarterly Report FY 13-14

April1- June 30, 2014

FOURTH QUARTER HIGHLIGHTS

• In May 2014, the Department was awarded a Healthy Homes Champions Award at the Advancing Safe and Healthy Housing Reception and Awards Ceremony in Nashville TN, sponsored by the Kresge Foundation and the National Center for Healthy Housing. Maricela Foster, ACHHD Director, accepted the Healthy Homes Champions Award in recognition of the Department's "collaborative multidisciplinary approach that exemplifies what is needed to make significant and lasting change."

• During the quarter, the ACHHD conducted a review of ASHHI healthy housing unit leveraged resources which identified over $342,000 in goods and services provided to participating projects. Collaboration partners including weatherization, vector control, minor home repair, community resources, and others expanded the impact of ASH HI funding to address multiple hazards. The Department is developing new tracking measures and training staff in order to more comprehensively capture the value of partnerships and referrals.

• This past quarter, ACHHD successfully completed a 12 month Kaiser Permanente Community Benefit Grant pilot project Coordinated Response to Asthma Management, and established a MOU with the Alameda County Public Health Department Asthma Start program to address asthma triggers in the home. ACHHD was invited by Kaiser Permanente to apply for the next round of funding and was successfully awarded $25,000 to continue the collaboration work with Asthma Start FY 2014-2015.

Maricela Foster, Director, accepting the Healthy Homes Champions Award,

Nashville, TN, May 2014

2

HEALTH DIVISION Key Accomplishments

• Seventy-five children with newly elevated blood lead levels received one of three types of health promotion services this quarter: nursing case management (3) , lead poisoning consultation (29), or lead poisoning outreach and education (43).

• Outreach to medical providers continued with multiple outreach strategies. Seven new providers were visited this quarter and received a provider tool-kit.

• The Promatoras Pilot Project under the Healthy Child Initiative continues to outreach directly to families at events, door-to-door and other sites. Over 200 unique families have been reached which has resulted in referrals to other Department services, including the ASHHI and Healthy Homes Projects.

• The ACHHD conducted internal chart reviews during FY 2013-2014 to assess outcomes for children with blood lead levels (BLL) in the 5-14 mcg/dl who received services in 2011. A total of 185 charts were reviewed over this fiscal year and results are summarized in the attached table. The results clearly demonstrate the effectiveness that outreach and home visiting has on reducing elevated lead levels; in particular for those that received home and/or telephone visits (BLL 7-14 mcg/dl) versus those that received health educational mailings (BLL 5-9 mcg/dl).

Blood Lead Level (BLL) Outcome Evaluation Summary:

BLL 7-14 in 2011 BLL 5-6 in 2011 Combined; BLLs 5-14 in 2011

Lead Poisoning Consultation Lead Poisoning Outreach & Education Home Visit Mailing LPC+LPOE

(LPC) (LPOE) I

# charts reviewed 35 150 185 # obtained follow-up BLL 32/35 (91%) 100/150 (66%) 132/185 (71%) #follow-up BLLs that decreased 32/32 (I 00%) 981100 (98%) 1301132 (98%)

# follow-up BLLs that increased 0/32 2/100 (2%) 21132 (2%) # follow-up BLLs- no change 0 0 0

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HOUSING SERVICES DIVISION Key Accomplishments

• The ACHHD applied for the US Department of Urban Development (HUD) Partnerships for Affordable Lead-Safe Housing Grant for $3.4 million to carry out lead hazard control and healthy housing interventions in up to 140 units over a three year period in the target cities of Oakland, Berkeley, Alameda, and Emeryville and the unincorporated communities of Ashland , Cherryland and San Lorenzo. To build community knowledge and skills, the ACHHD and partners will provide 2,894 individuals with lead and healthy housing education and train 392 individuals in lead safety and healthy housing skills. An award announcement is expected by the end of the calendar year 2014.

• The ACHHD also continues to have success in encouraging property owners to carry out healthy homes remediation . As an example, a joint project including the Oakland Housing Pilot, Asthma Start, Vector Control, Centro Legal de Ia Raza, and Community Energy Services Corporation, involved an owner making repairs including a new water heater, kitchen faucet, and new appliances. Department staff provided the owner with consultation and maintained communication among the partners, while code enforcement monitored the project to ensure subsequent repairs were done correctly and to assist with permits. Code enforcement confirmed all repairs were completed by June 301h and estimated property owner contributions were $14,000.

• The ACHHD continued to engage community stakeholders regarding substandard housing issues by presenting further "on the ground" data at the June 201h Alameda County Healthy Homes Alliance meeting with presentations by Just Cause/Causa Justa based on their report "Development Without Displacement" and the Goldman School of Public Policy at UC Berkeley's review of Proactive Rental Inspection programs in the state of California. Approximately 21 members of the Alliance were in attendance.

• The Department continues to increase the capacity of housing authorities to address lead safety and/or safe and healthy housing issues in their operations. In the quarter, ACHHD participated in an Oakland Housing Authority property owner appreciation event during Affordable Housing week and provided a workshop on lead and healthy homes issues that was attended by 91 property owners. Five units participating in the Section 8 program are enrolled in the HUD 19 lead hazard control program.

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OUTREACH AND COMMUNICATIONS DIVISION Key Accomplishments

Larry Brooks, ACHHD Director of Operations, and partnering organizations celebrating

"World Asthma Day" 2014

The ACHHD joined the Alameda County Asthma Coalition, Bay Area Air Quality Management District, and the Northern California Breathmobile in celebrating "World Asthma Day 2014" on May 6, 2014 to not only work on more solutions but also continue to raise awareness around Asthma.

Department video was completed during the quarter with interviews of 11 clients, homeowners, medical providers and community members. The video was posted on-line, shown at the Kresge Networking Meeting in May and is being utilized in presentations.

ACHHD provided input to Center for Environmental Health (CEH) about an outreach and education strategy for working with childcare operators to reduce flame retardant chemicals in childcares. Product Alerts from CEH and the Environmental Working Group are shared on our website and Facebook page.

Alameda County Board Supervisors representing Districts 2 and 4 sent letters to 48 medical providers in the Castro Valley and Hayward areas to inform of Healthy Child Initiative (HCI) services.

• During the quarter, 609 individuals increased their knowledge of lead poisoning prevention and/or healthy housing issues by participating in educational opportunities offered by the Department. The Department exceeded the expectations by reaching 1,981 individuals for the year; the objective for the year was 660 individuals.

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DEPARTMENT CHALLENGES • The objective of conducting environmental investigations at 25 properties of lead poisoned children was not reached this fiscal year. First, the total number of children with blood lead levels in the 15-19 mcg/dL range was less than last fiscal year, and second, the number of children with blood lead levels in the 15-19 mcg/dL range included some siblings of existing cases that did not warrant an additional environmental investigation . As a result of these factors, the environmental investigation eligibility criteria will now be made available for properties of lead poisoned children that receive visual assessments.

• Outreach to medical providers through the Healthy Child Initiative has not yet led to referrals to the Promotoras Pilot Project. As a result, the Promotoras are now outreaching directly to families to generate referrals via door-to-door , neighborhood events, community food banks, etc.

• In the quarter, the ACHHD faced barriers and challenges that slowed unit recruitment and production under the Lead Hazard Control grant. The ACHHD responded by increasing outreach and enrollment resources, revising eligibility requirements, and new marketing strategies, partnerships, and materials. To date the ACHHD has completed or has under construction 70 units out of the planned 125 units. An additional 27 units have received preliminary approval with lead inspections completed or in progress. Fifty-five units are in the application process. The ACHHD expects to reach 125 units by January 31 , 2015 and establish a strong waiting list for future lead hazard control grants. The ACHHD has exceeded benchmarks for lead evaluations, outreach and training for the year.

• The Department did not meet the objective for workforce development training this year. While the partnership with Laney Community College Carpentry Program remained strong, other agencies that ACHHD has traditionally worked with have de-emphasized construction as a focus or reduced trainee time for lead safety training. The ACHHD will be evaluating its training offerings and partners in this area in the new fiscal year.

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Appendix A: Services Provided to Date Fourth Quarter FY 2013-2014: A_Qril2014- June 2014

ACTIVITY

• Since the goal was not reached, environmental investigation eligibility criteria will be made available to

_p_l'(lQ_erties of LPCs that receive visual assessments. Conduct visual assessments and property owner compliance activities (PRWG) at an estimated 100 properties where lead exposed children reside.

• Visual assessments conducted at 73 properties, but at time of report data entry is still pending for 19.

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HOUSING SERVICES

Lead Hazard Control

Carry out an on-site lead safety survey in CSA housing to identify deteriorated paint and possible lead hazards. Provide technical assistance to property owners or their designees to assist them in identifying and correcting possible lead hazards. Healthy housing topics including mold and moisture, IPM, and safety issues will be included where appropriate.

Provide lead safety trainings Assess lead hazard risks and complete lead paint inspections at housing units. Complete lead hazard control and achieve clearance at housing units.

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Appendix A: Services Provided to Date Fourth Quarter FY 2013-2014: A_Qril2014- June 2014

ACTIVITY

Increase the capacity of local code enforcement agencies to promote compliance with lead safety requirements.

• Lead safety education materials available at permit offices.

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Develop working agreements for lead safety referrals with compliance agencies in jurisdictions. Finalize and promote model legislation for RRP certification requirement by local jurisdictions:

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• The ACHHD will be presenting to the East Bay Chapter of the International Code Conference in August on RRP certification requirements and examples of adoption by local programs.

Families in the Unincorporated Areas will increase their [ understanding of how mold and moisture in the home environment I i can impact health and how these issues can be addressed. _ I

• 21 calls were received in the quarter from Alameda (2), I 21 Berkeley (1), Oakland (13), Albany (1), Hayward (2), I

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OUTREACH AND EDUCATION

Public Awareness and Education

Participate in 20 partnership events and/ or presentations targeting CSA rental property owners and property managers, working with Oakland Housing Authority, Berkeley Housing Authority, Alameda Housing Authority, East Bay Rental Housing Association and property management companies. Provide 1,000 US EPA booklets Protect Your Family from Lead in Your Home" to CSA rentaLpropel'ty owners.

Provide ]Jresentations to grou]Js reaching_ CSA homeowners. Install and maintain poster displays, DVD's andjor distribute brochures about CSA services in venues including the four CSA permit offices, hardware and paint stores, and other venues visited

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*Preliminary data is 21,110 for children screened for lead. State of California has yet to complete the data.

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Publish articles ore-newsletters on lead and healthy housing topics targeting CSA property owners.

Particip_ate in health and community outreach fairs. 1 3 3

Provide information on lead-safe work practices and make display posters available to permit offices and paint and hardware stores outside the CSA within Alameda County. Distribute outreach and education materials about the need for blood lead screening and healthy housing topics at venues visited 1 3 8 by the public through-out Alameda County. Distribute lead prevention DVD's to organizations that reach at-risk familiesproperty owners and renovators. Individuals will increase their knowledge oflead poisoning prevention andjor healthy housing issues as demonstrated by participation in educational opportunities offered by the Department. Conduct presentations: -10 presentations reaching parents of young children and other at 1 3 3 risk individuals. (7) -16 presentations reaching professional staff and service providers 2 through agencies and community based organizations. (2) Provide individual consultations received from the public through the information line, e-mails and walk ins.

• Twenty five Infoline callers were asked for feedback about the quality of service they received when they initially contacted the Department. Sixty four percent of those surveyed said they took some action or had planned to take action as a result of

11 16 111 18 8 speaking with the Dept., including scheduling an In-Home Consultation, contacting other resources provided, or following instructions to reduce lead exposure.

• Ninety six percent said they would recommend our service to others, and included these comments: "I was quite satisfied about the service provided"; (staff was) "very helpful and nice".

*Preliminary data is 21,110 for children screened for lead. State of California has yet to complete the data.

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Appendix A: Services Provided to Date Fourth Quarter FY 2013-2014: April2014- June 2014

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4th Quarter FY 2014 (April - June 2014) lnfo line Feedback Resu lts

(total calls used = 25)

Was your question answered in a timely manner?

No/NA 0%

Yes 100%

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Did you take action as a result of speaking with us?

No/NA

Yes or plan to 64%

0 5 10 15 20

How did you hear about us?

Medical Referral

Brach u re/Fiyer /Presentation

City/Gov/Comm. Agency

Internet/Website

Friends/word of mouth

Prior contact

Don't know/Other

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4th Quarter FY 2014 (April - June 2014)

lnfoline Feedback Results, continued

Do you have any suggestions for improvement?

No/Not Yet

Yes- improved

communication/internet

Yes- expanded service

Yes-other

12%

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Would you recommend our service to others? I '

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No/Not sure 4%

Yes

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Do you require any additional information at this time?

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